About 20% of the US population lives in a rural community, from coal country mountains, farms and oil fields to ranches and tribal lands. While their surroundings may vary, rural residents in the US share an important characteristic: overall, they have poorer health than their city-dwelling fellow citizens do.
That gap has developed from factors including access to care, continuity of treatment and costs. Rural communities have fewer physicians or other providers and fewer health facilities. Since 2010, 83 rural hospitals have closed and those that remain often have limited services. More than half of rural counties in the US now lack hospitals that can deliver babies.
People must travel significant distance, sometimes for hours, to see a doctor or receive treatment. Specialists, such as cardiologists, oncologists or psychiatrists, are in short supply. Rural areas have only 30 specialists per 100,000 people, compared to 263 specialists per 100,000 urban dwellers, according to the National Rural Health Association.
Due to distance, poverty, lack of transportation or having no insurance, rural residents often delay getting medical care. That can cause chronic conditions and diseases to worsen by the time they finally see a doctor. Outcomes show the US rural-urban health gap in stark terms: rates of diabetes, heart disease, stroke, certain cancers, opioid overdoses and suicide are higher in rural areas. In 2014, the urban death rate was 704.3 per 100,000 people while the rural death rate was 830.5 per 100,000.
However, digital and connected technologies are helping overcome these challenges. In some places, this is already happening and much-needed change is being delivered through telehealth or telemedicine programs. These innovations use video, digital, wireless and mobile networks, devices and tools to deliver health care, monitoring and education.
“If anything, digital technologies are tailor-made for the rural setting,” says Susan Dentzer, President and CEO of the Network for Excellence in Health Innovation, a health policy institute. She points to the work of the University of Virginia’s telehealth program, which connects rural patients with medical services in more than 60 subspecialties. The program has cut at least 16 million miles of travel for rural patients since it began in 1996.
The widening adoption of telemedicine can provide an answer to the provider and service shortages in rural areas. “From a technological perspective, all of this could happen,” Dentzer says.